Iung et al reported a simple score for predicting early mortality following transcatheter aortic valve implantation (TAVI). This can help in determining an individual patient’s risk for the procedure. The authors are from multiple hospitals in France and Monaco participating in the FRANCE 2 registry.
Patient selection: transcatheter aortic valve implantation
Parameters:
(1) age in years
(2) body mass index (BMI) in kg per square meter
(3) NYHA functional class
(4) episodes of acute pulmonary edema (APE) in past year
(5) pulmonary hypertension (systolic pulmonary artery pressure in mm Hg)
(6) critical state
(7) respiratory insufficiency (obstructive or non-obstructive respiratory disease)
(8) dialysis
(9) approach
Critical state – one or more of the following:
(1) ventricular tachycardia or fibrillation
(2) aborted sudden death
(3) preoperative cardiac massage
(4) preoperative ventilation before arrival in the anesthetic room
(5) preoperative inotropic support
(6) intra-aortic balloon counterpulsation
(7) preoperative acute renal failure (anuria, oliguria with urine output < 10 mL per hour)
|
Parameter |
Finding |
Points |
|
age in years |
< 90 years of age |
0 |
|
|
>= 90 years of age |
1 |
|
body mass index |
>= 30 |
0 |
|
|
18.5 to 29.9 |
1 |
|
|
< 18.5 |
3 |
|
NYHA class |
I, II or III |
0 |
|
|
IV |
2 |
|
pulmonary edema episodes |
0 or 1 in past year |
0 |
|
|
>=2 in past year |
2 |
|
pulmonary hypertension |
no (systolic PAP < 60 mm Hg) |
0 |
|
|
yes (systolic PAP >= 60 mm Hg) |
1 |
|
critical state |
no |
0 |
|
|
yes |
3 |
|
respiratory insufficiency |
no |
0 |
|
|
yes |
2 |
|
dialysis |
no |
0 |
|
|
yes |
4 |
|
approach |
transfemoral or subclavian |
0 |
|
|
transapical |
2 |
|
|
other |
3 |
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21 (maximum value in Figure 1 is 14)
• The higher the score the greater the early mortality.
|
Score |
Percent Early Mortality |
|
<= 14 |
(0.2724 * ((points)^2)) + (1.004 * (points)) + 3.504 |
|
> 14 |
> 69% |
Specialty: Cardiology
